Pediatric Specialists of the NW MDSC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC SPECIALISTS OF THE NW MDSC

Practice address

5057 Shoreline Rd
Lake Barrington, IL 60010-1700

Phone

(847) 381-5005

Fax

(847) 381-5036

NPI assigned

Dec 9, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Charles M Braverman, MD

Title

Head Doctor

Phone

(847) 381-5005

Specialties & licenses 1

Addresses

Tax ID family

Pediatric Specialist of NW MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pediatric Specialist of the NW MDSC

  • Pediatrics Physician
  • Crystal Lake, IL
  • NPI 1598765521
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770568016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5057 SHORELINE RD",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600101700",
            "telephone_number": "847-381-5005",
            "fax_number": "847-381-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5057 SHORELINE RD",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600101700",
            "telephone_number": "847-381-5005",
            "fax_number": "847-381-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SPECIALISTS OF THE NW MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRAVERMAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "HEAD DOCTOR",
        "authorized_official_telephone_number": "847-381-5005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Owsley, PT, DPT
• Ankita Patel, M.D.
• Nilap Patel
• Sohal K Patel, MD.
• Shaina Peck, AGACNP-BC
• Pepper Road Endoscopy Center LLC
• Jack B Perlmutter, M.D.
• Samantha L Pohlman, PA
• Katherine L Pomerleau, PT
• Nistha Rawal, DO

• Pediatrics Physician in Lake Barrington, IL
• Providers in Lake Barrington, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.